VA disability claims · Decision letters

How to Read a VA Rating Decision Letter (Codes, Narrative, and What’s Missing)

The packet from VA is not one document with one job. Veterans call all of it “the letter.” Raters do not.

A rating decision explains what was granted, denied, or deferred, and why. An award letter (sometimes a benefits summary or generated award notification) is closer to payroll: combined rating, monthly amount, dependents, effective date. The codesheet is the coded spine underneath — diagnostic codes, percentages, effective dates, and often the SMC letter if one was assigned. If you only read the cover page dollar figure, you can miss the issue that actually matters next.

That miss is common at high ratings. The narrative may describe limited function. The combined line still says 90% or 100%. Special Monthly Compensation for loss of use, aid and attendance, or housebound status never appears as a lettered code. Or a single diagnostic code is frozen at an old percentage while daily life has moved. Those are different problems. They live in different parts of the same packet.

Veterans Promise is a veteran-led team based in Nashville. We work with veterans nationwide on rating increases and SMC. We start with the decision you already have, not with a slogan. This page is general information about how to read that packet. It is not legal or medical advice. Veterans Promise is not affiliated with the U.S. Department of Veterans Affairs. VA decides every claim. No one can honestly guarantee a result.

Request a complimentary consult or call (877) 778-0385. Email support@veteranspromise.com.

Rating decision vs award letter

Start by separating two jobs.

The rating decision is the reasoned document. In modern packets it usually includes an introduction, a list of issues decided, a list of evidence considered, and a “reasons and bases” (or similar) narrative for each condition. That is where VA says a knee is 20%, PTSD is 70%, tinnitus is 10%, or a claimed back condition is denied. It is also where effective dates and appeal rights show up.

The award letter or payment notice is the money page. It tells you the combined evaluation VA is paying, the monthly rate, whether dependents are on the award, and when payment starts or changes. It is useful. It is incomplete. A veteran can have a correct combined 100% on the award letter and still have an underrated individual code, a missing SMC letter, or a deferred issue that never came back.

If you only saved the page with the dollar amount, request the full rating decision from VA.gov’s claim-status / decision-letter tools, or from your VA.gov letters list. You cannot plan an increase or an SMC filing from a deposit amount.

VA’s own after-you-file page notes that a decision letter, when benefits are granted, includes the disability rating, the monthly payment, and the date payments start. That is the floor of what the packet should contain. It is not the whole file. See The VA claim process after you file.

Narrative vs codesheet

Inside the rating decision there are two languages.

The narrative is written for a human. It recites symptoms, exam findings, and the rating criteria VA applied. It will say things like “occupational and social impairment with deficiencies in most areas” or “flexion limited to X degrees.” Read it as a snapshot of what VA believed on the date of the decision — not as a biography of the rest of your life.

The codesheet (code sheet) is the coded list: each condition, a four-digit diagnostic code from the rating schedule, a percentage, an effective date, and flags such as whether a future exam is scheduled. Combined-evaluation math lives here. So do SMC pay codes when they were assigned. Some veterans receive a codesheet with the decision. Some only get it later in a claims-file request. If you do not have one, ask. The narrative can describe a loss of use in English while the codesheet still lacks the SMC letter that actually changes the check.

When the two conflict, the codesheet is what payment systems tend to follow. That is one reason a “looks right in the story, pays wrong on the deposit” problem is worth a human review rather than a Facebook guess.

Diagnostic codes, individual ratings, and the combined figure

Every rated condition sits on a diagnostic code (DC) from 38 C.F.R. Part 4. The number picks the criteria. 6260 is tinnitus. 5237 is a common lumbar-strain code. Mental-health codes share a general rating formula. You do not need to memorize the schedule. You do need to know which code VA used, because an increase is an argument about that code’s current severity, not about the combined line.

Individual ratings are the percentages next to each condition. The combined rating is VA’s “whole person” math — not addition. A 50% and a 50% do not equal 100%. At a combined 90%, a new 10% often does not round you to 100%. That math is why “I want an increase” at 90% is a different conversation than the same sentence at 40%. Details and current tables: 2026 disability rates and the increase page linked above.

When you read the letter, make a three-column list:

• What was decided (granted / denied / deferred).
• The individual percentage and diagnostic code for each grant.
• The combined rating actually being paid.

Then ask which column is the problem. A denied issue is not an increase. A granted issue whose percentage no longer matches function may be an increase. A combined 100% with a care need at home may be SMC, not another 10% on an old code. A new problem caused by a rated one may be a secondary condition.

Why SMC letters (K, L, S) get missed

SMC is not a higher combined percentage. It is a separate statutory payment. On a codesheet it shows up as a lettered level: K, L, S, and the letters above them. On an award letter it should change the rate, or add a K amount on top of the regular table. If nobody looks for the letter, nobody notices it is absent.

Typical misses:

• SMC-K. Loss or loss of use of a listed body part or creative organ was rated as a percentage and never paid as K. The narrative may mention erectile dysfunction, a prosthesis, or a foot that does not function as a foot. The combined line still looks ordinary.
• SMC-L (Aid & Attendance). A spouse already helps with bathing, dressing, meals, or safety. The mental-health or neurologic narrative describes that help. No one asked for A&A, and VA did not infer it. See VA Aid & Attendance.
• SMC-S (housebound). Either the veteran is substantially confined by service-connected disability, or the codesheet already has a single 100% disability plus additional disability independently ratable at 60% or more — the statutory housebound combination — and S was never assigned. See housebound benefits and what 100% does not cover.

SMC can be inferred in some files. In practice it is often missed unless someone reads the narrative against the SMC tests, not only against the percentage table. That is core work for us. It is not a reason to skip a real increase on a code that is still wrong. Read the SMC overview at Special Monthly Compensation if the letter describes loss of use, daily help, or confinement and the award still looks like a plain combined rating.

When the facts in the letter do not match daily life

A decision is a snapshot. Life continues. The useful question is not “do I dislike this letter.” It is “which facts are wrong, and which facts are new.”

If the letter already describes your typical week, and the percentage matches that description, fighting the old snapshot is usually the wrong fight. If the letter talks about “occasional” limitation and your week is built around the condition, that is a current-severity problem — generally a claim for increase, with current medical evidence, not a higher-level review that cannot take new records.

If the letter’s facts were wrong on the day it was written (the exam missed a device you use every day, a range-of-motion chart does not match the rest of the file, a secondary was never considered), that may be a decision-review question: supplemental claim with new and relevant evidence, higher-level review on the same record, or a Board appeal. Those clocks and lanes are technical. Bring the letter. Do not guess the form from a forum post.

If someone now helps you with personal care, if a limb is useless for its ordinary purpose, or if you are substantially confined, the mismatch may be SMC even when the combined rating is already high. 100% on the award letter is not a certificate that those questions were asked. More on that at 100% VA disability is not the ceiling.

Practical read-through:

1. List every condition and percentage. Note denials and deferrals.
2. Read the criteria VA quoted. Compare them to a typical week, not to a good hour in an exam room.
3. Look for SMC language — loss of use, aid and attendance, housebound — and then look for a K, L, or S on the award.
4. Check effective dates against when you filed or submitted an intent to file.
5. Check the evidence list. If a key record is missing from the list, VA may not have had it.

Then stop. The next filing should match that list. Piling every theory into one claim is how files stall.

Complimentary consult

Start with a conversation, not a contract pitch.

Veterans Promise does not bill five times the amount of a VA rating increase. The first conversation is a complimentary consult. Bring the rating decision if you have it. We will help you see whether the next step looks like an increase, a secondary, a decision review, or SMC.

We are veteran-led and based in Nashville. We assist veterans in every state. Rating increases and Special Monthly Compensation are both core work. We do not guarantee VA will change a letter, a percentage, or a payment. We are not the VA.

Call (877) 778-0385, email support@veteranspromise.com, or request a complimentary consult online.

FAQ

Is a VA rating decision the same as an award letter?

No. The rating decision explains what was granted or denied and why. The award letter is the payment summary: combined rating, monthly amount, dependents, effective date. You need the reasoned decision — and, when you can get it, the codesheet — to see whether a percentage or an SMC letter is missing.

What is a diagnostic code on a VA decision?

A diagnostic code is the four-digit number from VA’s rating schedule that tells the rater which criteria to apply. Your increase or disagreement is usually about that code’s percentage, not about the combined figure alone.

Why doesn’t my 100% letter mention SMC?

Because 100% is the top of the regular table, and SMC is a separate statutory benefit. If loss of use, a need for regular help, or housebound facts are in the narrative but no K, L, or S appears on the award, that gap is worth a review. It is not automatic entitlement. See our SMC and 100% / SMC pages.

The letter’s description of my condition is out of date. Do I appeal or file for increase?

If the condition has gotten worse since the decision, you are usually filing a new claim for increase, not a higher-level review. If you believe the decision was wrong on the evidence VA already had, that is a decision-review question. Bring the letter to the consult and we will separate “it got worse” from “they got it wrong.”

Can Veterans Promise review a decision I already have?

Yes. That is a normal use of the complimentary consult. We work with veterans who already have ratings, including at 90 and 100, on increases and on SMC.